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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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JIMENEZ, MALLORY ANN       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 5604 N. W. 41ST SUITE 231
OKLAHOMA CITY OK 73122

Address last updated on 10/21/2024
Phone #: (405) 495-3770 x1385
Fax #:
County: OKLAHOMA
License: 5285
Dated: 7/27/2017
Expires: 1/31/2025
License Type: Physical Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
5604 N. W. 41ST SUITE 231
OKLAHOMA CITY OK 73122

Phone #: (405) 495-3770 x1385
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
VICTORIA NOEMI ALVARADO TA 3138
MARY BRIANNA BRANCH TA 2892
NINA L BROWN TA 511
THAJA DAWN GILES TA 787
JOGI MATHEW PT 2867
LARESA DAWN MILLER TA 2706
BRANDI SUE MOORE TA 1503
KARRINGTON MCKENZIE MORRIS TA 3308
ANNETTE MARIE PHILLIPS TA 1692
KENDRA MICHELLE STEINLY TA 2678
SHANA RENEE STEPHENSON TA 2138

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